Implementing the WHO Safety Checklist in a Radiology Department

Size: px

Start display at page:

Download "Implementing the WHO Safety Checklist in a Radiology Department"

Harriet Powers
7 years ago
Views:

1 Implementing the WHO Safety Checklist in a Radiology Department Poster No.: C-1612 Congress: ECR 2012 Type: Authors: Keywords: DOI: Educational Exhibit H. Hirji, S. Desigan; London/UK Interventional non-vascular, Interventional vascular, Catheter arteriography, Percutaneous, Catheter venography, Health policy and practice, Audit and standards, Safety, Hemorrhage, Infection /ecr2012/C-1612 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Learning objectives This study evaluates the feasibility and efficacy of a surgical style safety checklist in an interventional radiology department. It seeks to identify barriers to implementation and discuss effective methodologies to aid introduction. Background The WHO 'Safe Surgery Saves Lives' checklist was developed by an international group of experts to improve the safety of patients undergoing surgical procedures. The National Patient Safety Agency (NPSA) and the United Kingdom's Chief Medical Officer issued an alert requiring all healthcare organisations in England and Wales to implement the surgical checklist by February This was demonstrated to be effective in the New England Journal of Medicine in January In 2009 the NPSA and Royal College of Radiologists published guidelines for their own checklist specific for interventional radiological procedures in March These follow the World Health Organisation Surgical Safety checklist. Intervention is defined under NPSA guidelines as 'any procedure which is dependent on penetration of the skin, other than the placement of an IV cannula'. As such it included procedures such as percutaneous biopsy, drainage or aspiration as well as endovascular procedures. Images for this section: Page 2 of 8

3 Fig. 1 Page 3 of 8

4 Fig. 2 Page 4 of 8

5 Imaging findings OR Procedure details The NPSA checklist was introduced in our department for all endovascular procedures and procedures requiring sedation such as nephrostomies. Initially the checklist was trialled by a limited number of interventional radiologists. This allowed rapid, responsive feedback in a controlled environment. During this time adjustments were made to the checklist to meet local practice. These included developing a simplified version checklist which was for ultrasound and CT guided procedures where general anaesthetic or sedation was not required. This excluded the sections on general anaesthetic included on the original checklist and reduced the number of steps in the initial assessment to better reflect departmental practice. Once this had been used for a period of three weeks, the checklist was then introduced to the rest of the department. The checklist was used by other radiologists who performed interventional procedures including registrars. At 3 months following implementation the utilisation was audited. The first 60 interventional cases were assessed. Initial utilisation was limited due to a lack of familiarity with the checklist among the radiographers and departmental assistants. While used for many cases completed forms were not routinely scanned into the PACS system and so an electronic record is not available. Improvements were achieved encouraging the nursing and radiographic staff to be involved rather than just the radiologists improved utilisation and by the end of a 3 month trial period the checklist was considered simple and quick to use by all staff. Potential omissions in patient preparation were identified at early stages using the checklist and were rectified in one case where prophylactic antibiotics were not administered on the ward. Some difficulties were experienced in ensuring the checklists were scanned onto the hospital PACS system for but this was remedied by further training. Images for this section: Page 5 of 8

6 Fig. 3: Example of the modified WHO checklist used for Ultrasound Guided and CT guided interventions. Simplification assisted utilisation. Page 6 of 8

7 Fig. 4: The checklist in use. Regular utilisation has made it an integral part of departmental safety. Page 7 of 8

8 Conclusion 1. Utilisation of a safety checklist is a cost effective and simple method to improve patient safety. 2. With practice, the checklist required less than a minute to complete. 3. An initial trial with a small motivated group within a department is recommended as it allows early modification in a controlled manner to meet local practice. 4. Modification and optimisation of the checklist for specific procedures increases the acceptability of the checklist for radiologists. 5. Inclusion of radiographers and nurses is essential to ensure the checklists are completed and the required preparations are completed. 6. Scanning the completed form into the PACS system is an efficient method of recording the completion of the checklist. 7. Open use of the checklist anecdotally provided reassurance for some patients prior to their procedures. Personal Information H. Hirji. S. Desigan. Department of Radiology, Northwick Park and St Marks Hospitals, Watford Road, Harrow, London. HA1 3UJ References 1. Haynes AB, Weiser TG, Berry WR et al. A surgical safety checklist to reduce morbidity and mortality in a global population. New Engl J Med 2009; 360, National Patient Safety Agency. Patient Safety Update: WHO Surgical Safety Checklist. London NPSA National Patient Safety Agency, The Royal College of Radiologists. WHO Surgical Safety Checklist: for radiological interventions only The Royal College of Radiologists. Guidelines for radiologists in implementing the NPSA Safe Surgery requirement. London: The Royal College of Radiologists The Royal College of Radiologists. Standards for the NPSA and RCR safety checklist for radiological interventions London: The Royal College of Radiologists 2010 Page 8 of 8

CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion

CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion Poster No.: E-0084 Congress: ESTI 2012 Type: Scientific Exhibit Authors: S. S. Shim, Y. Kim; Seoul/KR Keywords: